In 1965, the landmark legal decision Darling v. Charleston Community Hospital helped to establish the principle of corporate liability in the health care industry. Simply stated, a clinic can be held legally liable for the actions of its staff members (including contractors and volunteers). Proper credentialing and privileging helps to ensure that only qualified health professionals work in the clinic and that they do not practice outside the limits of their training and expertise, or beyond the capabilities of the clinic to support the services being provided.

Credentialing

Credentialing is the process of verifying that a dentist or dental hygienist has graduated from an accredited program or a postgraduate specialty training program (if applicable), his or her past history of practice (through letters of recommendation and an inquiry to the National Practitioner Data Bank (NPDB), and his or her current licensure. All licensed dentists and dental hygienists and support staff (e.g., dental assistants) requiring state certification should undergo the credentialing process.

Privileging

Privileging is the process whereby a health professional’s scope of services at the clinic is defined. The granting of privileges is based on the health professional’s training, experience, and practice history and the clinic’s ability to provide the support and services for which the health professional is privileged. In health care facilities with an organized medical and dental staff, a committee of health professionals and peers recommends the privileges to grant, based on each health professional’s qualifications. The final authority for granting of privileges generally rests with the governing body or board of directors. In a small clinic, where there may be only one dentist on staff, the chief executive officer or the board of directors grants privileges.

Plan de Salud del Valle (Salud Family Health Centers, Fort Lupton, CO) provides an example of a dental privileges request form.

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